No ghrelin response to oral glucose in diabetes mellitus with gastroparesis.
To investigate the role of ghrelin, an endogenous ligand of the growth hormone secretagogue receptor, in diabetic gastroparesis, we evaluated the plasma ghrelin profile during the oral glucose tolerance test in 55 patients with diabetes (men/women: 36/19, mean +/- SE of age: 55.1 +/- 1.7 years) with or without gastroparesis (diagnosed by the (13)C-acetate breath test). We also further examined cardiac autonomic neuropathy by assessing 24-hour variation of the R-R interval in randomly selected 32 patients with diabetes (men/women: 23/9, mean +/- SE of age: 54.2 +/- 2.5 years), and evaluated the influence of autonomic neuropathy on ghrelin. The fasting plasma ghrelin level was significantly lower in diabetes mellitus with gastroparesis than in healthy controls (7.9 +/- 0.7 fmol/ml versus 16.6 +/- 5.3 fmol/ml, p = 0.006). Patients with diabetes with gastroparesis showed no decrease of plasma ghrelin after glucose loading, unlike patients without gastroparesis or healthy controls. Diabetes mellitus with autonomic neuropathy, but not those without it, also showed no decrease of plasma ghrelin after glucose loading. Diabetic gastroparesis may be related to ghrelin-associated neurohormonal abnormalities, but the pathophysiological meaning of this abnormal ghrelin response needs further clarification.
Asai
Shiko
S
Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, Kawasaki, Japan.
Katabami
Takuyuki
T
Obi
Naoko
N
Matsui
Tomoya
T
Kato
Hiroyuki
H
Obi
Ryusei
R
Ogawa
Yutaka
Y
Kawata
Takehiro
T
Takama
Haruyuki
H
Ohta
Akio
A
Tanaka
Yasushi
Y
D000284:Administration, Oral; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000097:blood / Q000150:complications; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000378:metabolism; D003929:Diabetic Neuropathies / Q000097:blood / Q000378:metabolism; D015716:Electrocardiography, Ambulatory; D005260:Female; D018589:Gastroparesis / Q000097:blood / Q000150:complications* / Q000378:metabolism; D054439:Ghrelin / Q000097:blood* / Q000378:metabolism; D005947:Glucose / Q000008:administration & dosage*; D005951:Glucose Tolerance Test; D006331:Heart Diseases / Q000097:blood / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D054439:Ghrelin; D005947:Glucose